Extracorporeal shock wave therapy versus 1% xylocaine injection for myofascial trigger point release with novel analysis by sonoelastography

Introduction and background Extracorporeal shock wave therapy (ESWT) has become an alternative in the treatment of myofascial trigger points (MTPs). Sonoelastography has evidences in quantitative assessment of MTPs. Purpose This study tested the hypothesis that both radial ESWT (rEWST) and injection of 1% xylocaine are effective and safe treatments for active MTPs with novel analysis by sonoelastography. Design Prospective, randomized single blinded clinical trial. Material and method Patients ( n  = 20) with active MTPs of UTM were randomized to receive either rESWT ( n  = 10); three rESWT sessions; one session per week; 2000 rESWT impulses per session; positive energy flux density = 0.10 mJ/mm 2 ) or 1% xylocaine (4 ml) injection ( n  = 10) (three injections; one injection per week). The outcome measure was the elasticity score of MTPs assessed with sonoelastography, pain (VAS score), active range of motion of the neck, and McGill scores three weeks after baseline. Results Both rESWT and injection of 1% xylocaine resulted in statistically significantly ( P P P Conclusion Both rESWT and 1% xylocaine injection are effective and safe treatments of active MTPs of UTM. Ultrasound elastography appears useful for objectively monitoring treatment success.